“We expected more cases with more social mingling and, of course, as your show and others have seen, we’ve had a lot of social mingling in the last few weeks. And with that social mingling, we’re going to see more cases,” Atlas said. “By the way, with more testing, we’re going to detect more cases.”
This, of course, was Trump’s line: The increase (which Vice President Pence had a few weeks prior insisted wasn’t occurring) was simply a function of more testing, itself a triumph of the administration’s efforts. Go on, Dr. Atlas! Tell us more.
“The fact is, the overwhelming majority of these cases are younger, healthier people. These people do not have a significant problem. They do not have the serious complications. They do not die,” Atlas continued. “And so it’s fantastic news that we have a lot of cases but we don’t see deaths going up. And what that means is that, A, we’re doing a better job protecting the vulnerable, B, we’re in good shape here. We like the fact that there’s a lot of cases in low-risk populations because that’s exactly how we’re going to get herd immunity, population immunity.”
Great. Cases up because stay-at-home orders were scaled back, but no increase in deaths? A best-case scenario for a president looking to rationalize quickly ending efforts to contain the virus with an eye to seeing a big economic boost before his upcoming reelection bid.
When Atlas made those comments June 29 (indicated on the graph below), there were already signs that his assessment was overly optimistic. The number of new cases was in part a function of increased testing, but the rate of positive tests was also climbing as data from the Covid Tracking Project show. The number of new deaths each day had been falling, but it wasn’t hard to see how a surge in infections might eventually reverse that trend. After all, a positive test doesn’t immediately lead to the worst-case outcome. That tends to take a while.
By the beginning of August, the number of new cases had flattened, as had the positivity rate, but — again, predictably — the number of people being hospitalized had surged, as had the number of people dying of covid-19, the disease caused by the coronavirus. The country had not somehow magically shunted all of its new infections to populations who could gain immunity while avoiding death. It was simply letting more people become sick and letting more people die.
On July 23, Atlas appeared on Laura Ingraham’s Fox News show. Since his appearance on Carlson the prior month, the number of new cases each day was up by two-thirds, the number of new hospitalizations was up 90 percent, and the number of new deaths each day had increased by 55 percent to nearly 900.
Atlas was unfazed. Asked whether he agreed with Anthony S. Fauci, the government’s leading infectious-disease expert, that the pandemic posed a perfect-storm threat to public health, Atlas insisted it didn’t.
“Actually,” he said, “I’m cautiously optimistic because we actually know a lot now. We know the fatality rate is much lower, and we know who to protect. We are doubling down on the high-risk group. We are doing better with patients in the hospitals. I think we have to tell the American people, this is not out of control here.”
A month earlier, he celebrated that deaths weren’t increasing. Now he celebrated that deaths weren’t as high as they used to be.
He went on to praise the president’s approach.
“The strategy here that has been outlined by the briefings this week is very clear,” Atlas said, referring to the White House briefings. “We know that more relaxation is going to get more cases. By the way, you don’t eradicate a virus by locking down. That’s just a complete misconception. We know that with socializing, we are going to get more cases. We need to protect the vulnerable, double down on that. We need to make sure that hospitals are not overextended, and, in fact, most hospitals are not.”
This was the central component of Atlas’s approach: let it spread but protect those at risk. He maintained that position throughout his tenure at the White House, pushing back against the idea that it constituted an embrace of “herd immunity” — that is, slowing the virus’s spread by letting more people be exposed to it and building antibodies against it. But while he objected to the term, he was clearly open to the concept, as he had been in that June appearance on Carlson’s show.
Trump tapped Atlas to join his team in mid-August. He quickly butted heads with Fauci and other government experts who recognized the risk posed by the virus both in terms of death and long-term complications. But Fauci’s position didn’t change — and Trump was clearly inclined to heed Atlas’s advice. After all, that’s pretty obviously why he asked Atlas to join his team in the first place.
Only one part of Atlas’s three-part approach to combating the pandemic was actually enacted. That, unfortunately, was the part where Atlas shrugged at the spread of the virus itself. From the day that Atlas joined the task force to the day he resigned (Monday), the number of tests being conducted each day doubled but the number of new cases tripled. New hospitalizations were up 20 percent and deaths up a third — though those figures and the data on new cases are almost certainly too low as states scramble to catalogue data from the Thanksgiving holiday.
It is likely that there are more people being infected each day right now than at any previous point in the pandemic.
The other parts of Atlas’s plan — protecting those most vulnerable and ensuring that hospitals weren’t overwhelmed — have largely been neglected, as we’ve reported previously. Nursing homes and long-term care facilities continue to make up a disproportionate number of deaths from covid-19. Hospitals are facing significant bed shortages in a number of states. California, the country’s most populous state, may implement a new stay-at-home order as hospitals fill up.
There are worrying signs buried in the data. Ashish Jha, a dean at the Brown University School of Public Health, notes that the relationship between the number of new cases and the number of people admitted to the hospital has broken. From July 1 to Oct. 31, the number of people being newly admitted to the hospital averaged 3.7 percent of the number of new cases a week earlier. In recent weeks, though, that ratio has plunged to about 2 percent — which Jha worries is a function of hospitals being forced to turn away covid-19 patients viewed to be at lower risk.
At the same time, the ratio between the number of new cases to new deaths has also slipped. From July through October, the number of new deaths each day was about 1.8 percent of new cases two weeks before. That’s fallen to 1 percent in recent days, though it’s not clear why. When cases surged over the summer (shortly after Atlas was downplaying the increase on Carlson’s show), that ratio also dipped in the face of rapidly rising case totals, which may also be happening now.
There are a lot of reasons that case totals are surging now, including the seasonal change, which is both increasing the amount of time people spend inside and also provides more favorable air for the virus to linger. Part of it, too, is that the federal government has declined to encourage robust containment measures, both deferring strategies to the states and making it clear that Trump himself sees such niceties as mask-wearing as tedious. That there was little effort to discourage travel and gatherings at Thanksgiving may mean that the surge will accelerate over the short term.
All of this overlaps with Atlas’s time in Washington.
Ultimately, the federal response and its shortcomings isn’t a function of what Atlas did or didn’t do. It is a function of Trump. But Atlas will forever be the face of this phase of the pandemic response, the embodiment of the president’s rationalizing not taking significant steps to encourage containment efforts. Atlas said what Trump wanted to hear so Trump elevated him to say the same things to the American public.
Since Atlas joined the White House, the number of people who’ve contracted the virus has more than doubled and an additional 101,000 Americans have died of covid-19. That latter figure will almost certainly increase rapidly over the next few weeks, even as Atlas returns to the private sector.
He accomplished what he came to Washington to do.